MERCY HEALTH SERVICES INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HEALTH SERVICES INC (EIN 62-1781969)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-02-19
- IRS object ID
- 202010509349300401
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-02-19T04:27:53-06:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560574444 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 SECOND AVE SOUTH STE 1240 | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621781969 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 6157900567 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1113 MURFREESBORO ROAD NO 319 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RHONDA SIZEMORE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6157900567 | PhoneNum |
| Signature | 2020-02-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SARA G MOON | PreparerPersonNm |
| PTIN | P00034774 | PTIN |
| Phone | 6153836592 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 184.80.143.82 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-02-17 | IPDt |
| IP Tm | 17:07:22 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2FF319B3CE2B43652A7ED6DCC0B88F842DF00A82 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CINDY SILER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1113 MURFREESBORO ROAD NO 319 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,280,721 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYCOMMUNITYHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | MERCY HEALTH SERVICES, INC. REFLECTS THE LOVE OF JESUS CHRIST BY PROVIDING QUALITY HEALTHCARE TO THE INSURED AND UNINSURED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 176 | TotalEmployeeCnt |
| Total Volunteers | 400 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,692,403 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,242,933 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,966,997 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,864,524 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,505 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $184,898 | PYOtherRevenueAmt |
| CY Other Revenue | $61,494 | CYOtherRevenueAmt |
| PY Total Revenue | $8,845,803 | PYTotalRevenueAmt |
| CY Total Revenue | $9,168,951 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,242,639 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,378,792 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $223,869 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,661,521 | PYOtherExpensesAmt |
| CY Other Expenses | $1,932,426 | CYOtherExpensesAmt |
| PY Total Expenses | $7,904,160 | PYTotalExpensesAmt |
| CY Total Expenses | $9,311,218 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $941,643 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$142,267 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,025,717 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,965,335 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $770,079 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $851,964 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,255,638 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,113,371 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MERCY HEALTH SERVICES, INC. REFLECTS THE LOVE OF JESUS CHRIST BY PROVIDING QUALITY HEALTHCARE TO THE INSURED AND UNINSURED SERVING WILLIAMSON COUNTY AND SURROUNDING COUNTIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,675,250 | ExpenseAmt |
| Revenue | $6,864,524 | RevenueAmt |
| Desc | IN THE FISCAL YEAR 2018-2019:1. MERCY SAW 11,069 UNIQUE PATIENTS WITH 62,000 VISITS.2. THE MAIN SITE IN FRANKLIN ACHIEVED PRIMARY CARE MEDICAL HOME LEVEL 2 CERTIFICATION.3. NEW FACILITY IN LEWISBURG, MARSHALL COUNTY HEALTH CENTER, OPENED FULL TIME IN APRIL. THE FACILITY GENERATED AN ADDITIONAL 629 VISITS DURING THE LAST THREE MONTHS OF THE YEAR AND CONTINUING TO GROW AT A STEADY PACE.4. INCREASED OUR SCHOOL-BASED COUNSELING PROGRAM PARTICIPATION FROM 8 SCHOOLS IN 2 DISTRICTS TO 31 SCHOOLS 3 DISTRICTS. SERVICES CONTINUE TO BE IN DEMAND, WITH MORE AND MORE SCHOOLS ASKING US TO JOIN THEM. | Desc |
| Total Program Service Expenses | $7,675,250 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 176 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RHONDA SIZEMORE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6157900567 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1113 MURFREESBORO ROAD STE 319 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| CRAIG BALLENTINE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DUMKELE ANIFOWOSHE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GONZALO ALORZA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE LAMPLEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KENT WALTMAN | |||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KIMBERLY ALIOTTE | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KRISTEN TOTH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LUPITA MARTINEZ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LYDIA MABEL ARROYO | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT PIATKO | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| REBECCA DYER | |||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TANIA DAVILA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TODD MATTHEWS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALEX BRUNNER MD | |||||||
| CMO | 40.00 | $158,447 | $0 | $18,942 | Yes (X) | ||
| CINDY SILER | |||||||
| CEO | 40.00 | $118,352 | $0 | $12,387 | Yes (X) | ||
| DOROTHY BULLARD | |||||||
| CICCO | 40.00 | $86,500 | $0 | $6,171 | Yes (X) | ||
| JONATHAN BOYE | |||||||
| CHIEF BEH HLTH | 40.00 | $110,092 | $0 | $20,650 | Yes (X) | ||
| MARGARET OWENS | |||||||
| CCO | 40.00 | $79,791 | $0 | $14,230 | Yes (X) | ||
| MARI GARNER | |||||||
| COO | 40.00 | $63,467 | $0 | $19,674 | Yes (X) | ||
| RHONDA SIZEMORE | |||||||
| CFO | 40.00 | $82,661 | $0 | $18,699 | Yes (X) | ||
| ABIGAIL RYAN | |||||||
| DOCTOR | 32.00 | $136,152 | $0 | $14,015 | Yes (X) | ||
| AMY VEHEC | |||||||
| DOCTOR | 40.00 | $146,881 | $0 | $8,341 | Yes (X) | ||
| ANNE FOTTRELL | |||||||
| PSYCHIATRIST | 40.00 | $142,806 | $0 | $7,783 | Yes (X) | ||
| DEANNA BROWN | |||||||
| DOCTOR | 32.00 | $142,767 | $0 | $21,112 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,267,916 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $162,004 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $50,000 | FederatedCampaignsAmt |
| Fundraising | $57,900 | FundraisingAmt |
| Government Grants | $1,356,283 | GovernmentGrantsAmt |
| All Other Contributions | $778,750 | AllOtherContributionsAmt |
| Noncash Contributions | $35,502 | NoncashContributionsAmt |
| Total Contributions | $2,242,933 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $6,864,524 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,864,524 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,864,524 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $150,379 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $57,900 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $111,770 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,609 | TotalRevenueColumnAmt |
| Exclusion | $38,609 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $22,885 | TotalRevenueColumnAmt |
| Exclusion | $22,885 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $22,885 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,168,951 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,864,524 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $61,494 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,312 | TotalAmt |
| Program Services | $620,908 | ProgramServicesAmt |
| Management And General | $111,794 | ManagementAndGeneralAmt |
| Fundraising | $9,610 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,478,087 | TotalAmt |
| Program Services | $4,582,154 | ProgramServicesAmt |
| Management And General | $825,011 | ManagementAndGeneralAmt |
| Fundraising | $70,922 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,357 | TotalAmt |
| Program Services | $29,096 | ProgramServicesAmt |
| Management And General | $7,000 | ManagementAndGeneralAmt |
| Fundraising | $261 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,704 | TotalAmt |
| Program Services | $529,548 | ProgramServicesAmt |
| Management And General | $127,401 | ManagementAndGeneralAmt |
| Fundraising | $4,755 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,332 | TotalAmt |
| Program Services | $387,818 | ProgramServicesAmt |
| Management And General | $66,365 | ManagementAndGeneralAmt |
| Fundraising | $6,149 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,512 | TotalAmt |
| Program Services | $64,710 | ProgramServicesAmt |
| Management And General | $112,596 | ManagementAndGeneralAmt |
| Fundraising | $206 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,442 | TotalAmt |
| Program Services | $704 | ProgramServicesAmt |
| Fundraising | $96,738 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,023 | TotalAmt |
| Program Services | $130,157 | ProgramServicesAmt |
| Management And General | $47,905 | ManagementAndGeneralAmt |
| Fundraising | $9,961 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,780 | TotalAmt |
| Program Services | $245,895 | ProgramServicesAmt |
| Management And General | $47,026 | ManagementAndGeneralAmt |
| Fundraising | $3,859 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $332,271 | TotalAmt |
| Program Services | $318,654 | ProgramServicesAmt |
| Management And General | $8,367 | ManagementAndGeneralAmt |
| Fundraising | $5,250 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,410 | TotalAmt |
| Program Services | $11,558 | ProgramServicesAmt |
| Management And General | $6,209 | ManagementAndGeneralAmt |
| Fundraising | $643 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,061 | TotalAmt |
| Program Services | $114,526 | ProgramServicesAmt |
| Management And General | $2,535 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,542 | TotalAmt |
| Program Services | $47,724 | ProgramServicesAmt |
| Management And General | $5,719 | ManagementAndGeneralAmt |
| Fundraising | $99 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $269,468 | $269,369 | $99 | |
| REPAIRS & MAINTENANCE | $134,110 | $112,727 | $21,058 | $325 |
| LAB SERVICES | $93,842 | $93,842 | ||
| BAD DEBT EXPENSE | $53,733 | $53,586 | $147 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,232 | TotalAmt |
| Program Services | $62,274 | ProgramServicesAmt |
| Management And General | $22,867 | ManagementAndGeneralAmt |
| Fundraising | $15,091 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,311,218 | TotalAmt |
| Program Services | $7,675,250 | ProgramServicesAmt |
| Management And General | $1,412,099 | ManagementAndGeneralAmt |
| Fundraising | $223,869 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,438 | BOYAmt |
| EOY | $96,528 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $858,045 | BOYAmt |
| EOY | $401,061 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,159,773 | BOYAmt |
| EOY | $1,462,483 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,098 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,910 | BOYAmt |
| EOY | $10,461 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,030,632 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,037,395 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $974,453 | BOYAmt |
| EOY | $993,237 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,565 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,025,717 | BOYAmt |
| EOY | $2,965,335 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $608,610 | BOYAmt |
| EOY | $729,079 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,000 | BOYAmt |
| EOY | $10,115 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,469 | BOYAmt |
| EOY | $112,770 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $770,079 | BOYAmt |
| EOY | $851,964 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,255,638 | BOYAmt |
| EOY | $2,113,371 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,255,638 | BOYAmt |
| EOY | $2,113,371 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,025,717 | BOYAmt |
| EOY | $2,965,335 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$142,267 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,364,524 | OtherCostOrOtherBasisAmt |
| Depreciation | $659,841 | DepreciationAmt |
| Book Value | $704,683 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $521,527 | OtherCostOrOtherBasisAmt |
| Depreciation | $330,055 | DepreciationAmt |
| Book Value | $191,472 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $144,581 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,499 | DepreciationAmt |
| Book Value | $97,082 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $993,237 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED LEASE LIABILITY | Desc |
| Amt | $112,770 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $112,770 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $9,280,721 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $111,770 | OtherRevenueAmt |
| Revenue Not Reported | $111,770 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,168,951 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,168,951 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,422,988 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $111,770 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $111,770 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,311,218 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,311,218 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 111,770. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 111,770. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FRANKLIN CLASSIC | Event1Nm |
| Gross Receipts Event1 | $129,851 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $129,851 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $86,175 | OtherDirectExpensesEvent1Amt |
| Event2 | PRAYER DINNER | Event2Nm |
| Gross Receipts Event2 | $30,789 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $18,988 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $11,801 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $14,480 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 4 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $47,639 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $38,912 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $8,727 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $11,115 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $208,279 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $57,900 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $150,379 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $111,770 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $111,770 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $38,609 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEX BRUNNER MD | ||||||||||||||
| CMO | $152,318 | $0 | $6,129 | $0 | $0 | $0 | $0 | $0 | $18,942 | $0 | $177,389 | $0 | $0 | $0 |
| ABIGAIL RYAN | ||||||||||||||
| DOCTOR | $135,771 | $0 | $381 | $0 | $0 | $0 | $2,129 | $0 | $11,886 | $0 | $150,167 | $0 | $0 | $0 |
| AMY VEHEC | ||||||||||||||
| DOCTOR | $141,230 | $0 | $5,651 | $0 | $0 | $0 | $2,170 | $0 | $6,171 | $0 | $155,222 | $0 | $0 | $0 |
| ANNE FOTTRELL | ||||||||||||||
| PSYCHIATRIST | $142,705 | $0 | $101 | $0 | $0 | $0 | $1,612 | $0 | $6,171 | $0 | $150,589 | $0 | $0 | $0 |
| DEANNA BROWN | ||||||||||||||
| DOCTOR | $136,814 | $0 | $5,953 | $0 | $0 | $0 | $2,170 | $0 | $18,942 | $0 | $163,879 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | FUNDRAISING SUPPLIES | 391 | $24,162 | FMV |
| Yes (X) | OFFICE FURNITURE | 98 | $11,340 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | N/A - THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT OF FORM 990 WILL BE SENT ELECTRONICALLY TO THE BOARD OF DIRECTORS PRIOR TO FILING. ADDITIONALLY, IT IS REVIEWED IN DETAIL BY THE EXECUTIVE COMMITTEE WHICH REPORTS ITS FINDINGS TO THE FULL BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | POLICIES AND PROCEDURES FOR ALL PROCUREMENT ARE IN PLACE TO DISCOVER ANY POTENTIAL CONFLICTS OF INTEREST FOR ALL PURCHASES AND CONTRACTS. ANNUALLY FORMS ARE SIGNED TO STATE THERE IS NO CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE CEO IS REVIEWED AND DETERMINED EACH YEAR BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MERCY. PRIMARILY, THE COMMITTEE USES THE COMPENSATION REPORT DONE EVERY TWO YEARS BY THE TENNESSEE PRIMARY CARE ASSOCIATION OF ALL THE FEDERALLY QUALIFIED HEALTH CENTERS IN TENNESSEE. THIS REPORT IS VERY HELPFUL IN COMPARING THE BUDGET SIZES, PATIENT ENCOUNTER NUMBERS, AND STAFFING SIZES OF THESE CENTERS IN ORDER TO REACH A COMPETITIVE SALARY RANGE. THE REMAINDER OF THE TOP MANAGEMENT OFFICIALS' COMPENSATION IS DETERMINED, PRIMARILY USING THE SAME COMPENSATION REPORT BY THE CEO OF MERCY. EACH YEAR, BUDGET PERMITTING, A COST OF LIVING RAISE IS IMPLEMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
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